Anesthesiology often solicits the management of emergencies, both patient and doctor induced like massive hemorrhage, increased intracranial pressure, cardiac disease, drug-related errors and surgical errors. This article offers a brief prologue, followed by the management of these conditions.

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to drop, check the lungs and make sure
that you're not filling them with fluid. So,the next thing we're going to talk about is
Increased Intracranial Pressure. Our brain iscontained within a box. And within that box
there are only a few substances.
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There is Blood. There's Intracellular
fluid. There's InterstitialFluid, which is the fluid between the cells.
And there's Cerebral Vascular Fluid that isthe fluid that bathes the brain cells within
the brain, and goes down throughthe spinal column and bathes
cells within the spinal column.
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Any increase in any one of those without a corresponding
decrease in one of the others, resultsin an increase pressure within the cranium.
And that increased pressure,if it goes to its worst level, can result
in the brain, actually the brainstem, beingforced out of the skull through the Foramen
Magnum at the base of the skull,which is almost always associated with sudden
death. Intubation by the anesthesiologistincreases intracranial pressure, usually by increasing
blood pressure and heart rate. Unfortunately,that can be quite a serious problem, but we
can correct it by inducing anesthesiawith our normal induction agents, which
tend to lower blood pressure and may alsoreduce cerebral blood flow and increase the probability
of ischemic brain damage if we drop the bloodpressure too much. The careful use of anesthetic
drugs to reduce pressure, but maintaincerebral perfusion, is a real art. And people who are
neuro anesthetists spend all their time discussingthis issue. Diuretics such as loop diuretics,
Furosemide, and osmotic agents,such as Mannitol, basically suck water
out of the cells and cause it to be lostthrough the kidney. So they reduce the size
of the brain and reduce the pressure in the skull.
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How about other types of cardiac disease
and cardiac arrest? We've talked about

About the Lecture

The lecture Increased Intracranial Pressure – Patient and Doctor Induced Emergencies by Brian Warriner, MD is from the course Emergencies.

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